Healthcare Provider Details

I. General information

NPI: 1619431202
Provider Name (Legal Business Name): INFINITE HEALTH CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 CERRILLOS RD STE C2
SANTA FE NM
87507-2326
US

IV. Provider business mailing address

2860 CERRILLOS RD STE C2
SANTA FE NM
87507-2326
US

V. Phone/Fax

Practice location:
  • Phone: 505-772-0114
  • Fax:
Mailing address:
  • Phone: 505-772-0114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS SANDOVAL
Title or Position: OWNER
Credential: DC
Phone: 505-772-0114